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Lung Cancer 

1. What is Lung Cancer? 

In short, lung cancer is an abnormal growth of cells in the lungs. Lung cancer may eventually spread to other parts of the body if not discovered and treated early. 

2. What are the risk factors for Lung Cancer?

Smoking is the single greatest avoidable risk factor for cancer. It is responsible for one in four of all deaths from cancer in the UK. Smoking causes around 90% of lung cancers.

There are benefits from quitting, once you stop smoking, your risk of lung cancer starts to go down. 10 years after you've given up, your lung cancer risk is about half that of a smoker.

3. What causes Lung Cancer? 

The most significant cause of lung cancer is cigarette smoke (National Cancer Institute). Roughly 85 percent of lung cancers are diagnosed in former or current smokers; other cases may be caused by environmental exposure to materials like radon, asbestos or uranium, or secondhand smoke. Genetics can also play a role. 

4. I have been smoking for many years? Why should I stop smoking now?

Lung cancer takes years to develop. The risk increases with each year of smoking, and with each cigarette smoked per day. Stopping smoking will reduce the risk of cancer developing. Smoking also increases the risk of other diseases, such as chronic lung disease, heart disease, stroke and other cancers such as head and neck cancers. Stopping smoking will reduce the risk of lung cancer developing as well as reduce the likelihood of developing heart and lung problems.  Smoking can also harm your spouse and family members

5. Do non-smokers get Lung Cancer?

Yes, non-smokers can get lung cancer, but the risk is much lower than in smokers. There are factors other than smoking that increase a person's risk of getting lung cancer. Breathing in other people's smoke, exposure to radon, asbestos, air pollution, certain chemicals in the workplace, and a personal or family history of lung cancer are also risk factors for lung cancer.

6. What Lung Cancer risks are associated with second-hand smoke? 

Second-hand smoke contains twice as much tar and nicotine per unit volume than the smoke inhaled directly from a cigarette. More significantly, second-hand smoke contains three times more cancer-causing compounds and 30 times more carbon monoxide than firsthand smoke. Second-hand smoke is responsible for thousands of cases of lung cancer and asthma each year.

7. Why is early Lung Cancer screening important? 

Because lung cancer has no symptoms in its early stages, more than 85 percent of the men and women who are diagnosed with lung cancer today are diagnosed in a late stage, after symptoms have occurred and when there is very little chance of cure. As a result, approximately 95 percent of the more than 221, 000 people diagnosed each year die from the disease. 

8.    What are the most common symptoms of Lung Cancer?

This is a tricky one because sometimes there aren't any symptoms of lung cancer. One in four people don’t even have symptoms when their lung cancer is advanced. In other people, symptoms that may suggest lung cancer can include:

  • Shortness of breath
  • Coughing that doesn't go away
  • Wheezing
  • Coughing up blood
  • Chest pain
  • Fever
  • Weight loss

9. What are the tests for Lung Cancer? 

There are a number of tests that can be used to detect lung cancer. However, most tests miss many early cancers, and are often ordered only after the patient has started having symptoms. Traditional lung cancer tests include chest x-ray, sputum cytology (analyzing cells in mucus), and bronchoscopy (using a tube through the mouth to look at the lungs with a tiny camera). 
To confirm that a person has lung cancer, the doctor must examine fluid or tissue from the lung. This is done through a biopsy -- the removal of a small sample of fluid or tissue for examination under a microscope by a pathologist. A biopsy can show whether a person has cancer. A number of procedures may be used to obtain this tissue.

  • Bronchoscopy: The doctor puts a bronchoscope -- a thin, lighted tube -- into the mouth or nose and down through the windpipe to look into the breathing passages. Through this tube, the doctor can collect cells or small samples of tissue.
  • Needle Aspiration: The doctor numbs the chest area and inserts a thin needle into the tumor to remove a sample of tissue.
  • Thoracentesis: Using a needle, the doctor removes a sample of the fluid that surrounds the lungs to check for cancer cells.
  • Thoracotomy: Surgery to open the chest is sometimes needed to diagnose lung cancer. This procedure is a major operation performed in a hospital.
  • PET-CT

10. What are the standard treatments for Lung Cancer?

  • Surgery is an operation to remove the cancer. Depending on the location of the tumor, the surgeon may remove a small part of the lung, a lobe of the lung, or the entire lung.
  • Conventional Chemotherapy uses anti-cancer drugs to kill cancer cells throughout the body. Doctors use chemotherapy to control cancer growth and relieve symptoms. Anti-cancer drugs are given by injection; through a catheter, a long thin tube temporarily placed in a large vein; or in pill form.
  • Targeted agents and Immunotherapy are a newer class of drugs that are designed to act against specific weaknesses in cancer cells or surrounding supportive tissues, such as blood vessels. These drugs can also be taken by pill or by IV. They are most effective in cancers with specific changes in their genes.
  • Radiation Therapy uses high-energy beams to kill cancer cells and shrink tumors. An external machine delivers radiation to a limited area, affecting cancer cells only in that area. Doctors may use radiation therapy before surgery to shrink a tumor or after surgery to destroy any cancer cells remaining in the treated area.

11. What are the treatment options for the Lung Cancer that has spread to other parts of the body?

Almost 60-70% of patients have advanced of lung cancer. Further tests of the biopsy specimen to subtype the cancer further may help determine whether chemotherapy or targeted therapy will be more suitable. The goal of treatment in such cases is to improve quality of life and/or reduce symptoms and also prolong the survival. Currently, such patients live longer and also well.

12. What types of surgery are used to treat Lung Cancer?

Depending on the extent of the cancer, the surgeon may decide to remove part or all of the lung. Taking out a part of the lobe of a lung is called a segmental or wedge resection. If a lobectomy is performed, an entire lobe of the lung is removed. This is usually the preferred surgery for lung cancer if it can be done. A pneumonectomy is the removal of an entire lung. A sleeve resection removes only the part of the bronchus with cancer. The lung is then reattached to the remaining part of the bronchus. Although these surgeries are done by open thoracotomy, video assisted thoracoscopic surgeries (VATS) at performed at our centre through keyholes.

13. After a lung is removed, what happens to the space that's left in the chest?

Space left after surgery becomes filled up with body fluid and scar tissue and the other lung usually expands. Until this happens, there may be a feeling of emptiness on the side of the operation.

14. Can I breathe and live normally if I have a Lung removed?

Most likely, depending on your lung function before the surgery. The removal of 1 or 2 lobes may limit hard physical exercise. Otherwise you should be able to breathe and live normally. If you have an entire lung removed, you may become short of breath when you exert yourself, but at rest you will breathe normally. Breathing exercises will help you adjust to this.

15. What are some common side effects of Chemotherapy?

The most common side effects of chemotherapy include nausea and vomitting , however, medications known as antiemetics are available to help control these side effects. Other common side effects include mouth sores, fatigue, anemia, dizziness, infection, pain, hair loss, and loss of appetite.

16. Will they go away?

Yes, temporary side effects like nausea, vomitting, hair loss, and fatigue usually go away following the completion of treatment.

17. Can I work during treatments?

Some people benefit from keeping to a regular work schedule with flexibility if they don't feel well. Some schedule chemotherapy for Fridays so that they have time over the weekend to recover. Others may want to take medical leave from work. Talk to your oncologist.

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